Smile Dental Design, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019025326 Issued in IL

Legal business name

SMILE DENTAL DESIGN, LLC

Practice address

282 McHenry Rd
Wheeling, IL 60090-3202

Phone

(847) 235-6859

Fax

(847) 235-6958

NPI assigned

Mar 20, 2012

Last updated

Mar 20, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Joo Han Kwon, D.D.S.

Title

President

Phone

(847) 235-6859

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332201600000",
    "number": "1629343892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "282 MCHENRY RD",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600903202",
            "telephone_number": "847-235-6859",
            "fax_number": "847-235-6958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 MCHENRY RD",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600903202",
            "telephone_number": "847-235-6859",
            "fax_number": "847-235-6958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE DENTAL DESIGN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-20",
        "last_updated": "2012-03-20",
        "status": "A",
        "authorized_official_last_name": "KWON",
        "authorized_official_first_name": "JOO",
        "authorized_official_middle_name": "HAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-235-6859",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019025326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Wheeling, IL
• Providers in Wheeling, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.